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True transgender people exist, born with sexual organs of both sexes.
Historically these unfortunate individuals are often "Assigned" a sex by parents and physicians, and then attempt to culturally adapt. It is a very difficult road in any event, and the caregivers don't always make the best choices.
Biologically transgender individuals are unable to bear children, lacking the necessary female parts; however, it is theoretically possible some may be able "Father" children.